| NPI | 1740480870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY DAVID MIDDAUGH President 239-481-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC0002377) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2008-06-20 |